Cost kept a larger percentage of Tennesseans out of the doctor's office from 2000 to 2010 than it did citizens of any other state, according to a new study by the Robert Wood Johnson Foundation and the Urban Institute.

About 857,000 Tennesseans between the ages of 19 and 64 said in surveys over the last decade that they didn't go the doctor because they couldn't afford it. The number grew 10.8 percent from 2000 to 2010, higher growth than any other state.

"Tennessee was seeing increases in unmet need in particular for both the insured and uninsured that were large relative to the national averages," said study co-author Steve Zuckerman. "But the deterioration for the uninsured was particular pronounced."

The study, released Tuesday, said 55.6 percent of uninsured Tennesseans skipped a doctor visit in 2010 because they couldn't afford it and 12.6 of those with insurance did the same.

The study did not offer any reasons for increases in unmet medical need in any state. But Gordon Bonnyman, executive director of Nashville's Tennessee Justice Center, said they are directly linked to TennCare cuts.

"We went, in 2000, from having very broad coverage in TennCare in terms of eligibility and benefits to being one of the most restrictive states in the country in terms of eligibility and what we cover," said Bonnyman.

The study said the potential benefits of the Affordable Care Act could be "large and exist in every state." However, Zuckerman said the report was not a policy paper supporting the health reform law.

The study also found that nearly 10 percent fewer Tennesseans had a dental visit over the decade. Also, the amount of those who had a routine health checkup stayed about the same.